Efficacy of the Ubiquitous Spaced Retrieval-based Memory Advancement and Rehabilitation Training (USMART) program among patients with mild cognitive impairment: a randomized controlled crossover trial

Abstract

BackgroundSpaced retrieval training (SRT) is a nonpharmacological intervention for mild cognitive impairment (MCI) and dementia that trains the learning and retention of target information by recalling it over increasingly long intervals. We recently developed the Ubiquitous Spaced Retrieval-based Memory Advancement and Rehabilitation Training (USMART) program as a convenient, self-administered tablet-based SRT program. We also demonstrated the utility of USMART for improving memory in individuals with MCI through an open-label uncontrolled trial.MethodsThis study had an open-label, single-blind, randomized, controlled, two-period crossover design. Fifty patients with MCI were randomized into USMART–usual care and usual care–USMART treatment sequences. USMART was completed or usual care was provided biweekly over a 4-week treatment period with a 2-week washout period between treatment periods. Primary outcome measures included the Word List Memory Test, Word List Recall Test (WLRT), and Word List Recognition Test. Outcomes were measured at baseline, week 5, and week 11 by raters who were blinded to intervention type. An intention-to-treat analysis and linear mixed modeling were used.ResultsOf 50 randomized participants, 41 completed the study (18% dropout rate). The USMART group had larger improvements in WLRT score (effect size = 0.49, p = 0.031) than the usual care group. There were no significant differences in other primary or secondary measures between the USMART and usual care groups. Moreover, no USMART-related adverse events were reported.ConclusionsThe 4-week USMART modestly improved information retrieval in older people with MCI, and was well accepted with minimal technical support.Trial registrationClinicalTrials.gov NCT01688128. Registered 12 September 2012.

Meta-Analysis on the Effectiveness of Virtual Reality Cognitive Training (VRCT) and Computer-Based Cognitive Training (CBCT) for Individuals with Mild Cognitive Impairment (MCI)

“…The training mode of CBCT is convenient and has lots of possibilities. CBCT enables tailor-made and standardized interventions, real-time monitoring of individual's cognitive performance, adjustment of intervention levels, and reduced implementation costs, which makes CBCT simple and easy to operate [45,46]. The training mode is flexible to operate either in self-administered form or with therapists' support.…”

“…According to Han et al (2017), the Ubiquitous Spaced Retrievalbased Memory Advancement and Rehabilitation Training (USMART) program could not improve individuals' SMCQ and MMSE scores, indicating that efficacy cannot be transferred to general cognitive function, which is the highest level in the hierarchy of generalization. Achieving the lowest level of generalization indicates training efficacy can only be transferred to other non-trained tasks in the same cognitive domain [15,45]. In terms of set-up, regular updates of software packages and touchscreens are required depending on the system, which may increase the possible maintenance fee [47].…”

Effects of functional tasks exercise on cognitive functions of older adults with mild cognitive impairment: a randomized controlled pilot trial

“…With recognition of the implausibility of developing a cure or effective treatment for dementia within a decade [6], mild cognitive impairment (MCI), the prodromal stage of dementia, becomes an area of particular interest in research [7, 8]. Individuals with MCI are at increased risk of progressing to Alzheimer’s diseases and other dementias, with an annual conversion rate of 12–15% compared with 1–2% in their healthy peers [9] and this may even increase up to 50% in 2–3 years [10].…”

Cognitive training in fully immersive virtual reality improves visuospatial function and fronto-occipital functional connectivity in a pre-dementia state: A randomized controlled trial

“…Previous studies showed that repeated memory-focused training might have enhanced the processing speed of memory retrieval and e ciency of working memory, leading them to assume that frontal executive function was the main recipient of the transfer effects [73,74]. Although recent studies have applied cognitive training with novel computerized tools, with involvement of multiple cognitive domains, existing programs have only applied cognitive training in a 2D environment with an emphasis on language abilities [9,47,73,75]. Since frontal executive function plays a major role in all cognitive domains and higher-order cognitive controls [76], the improved performance on the RCFT copy task may be supported by increased FC in the frontal-occipital network.…”